2019 Fiscal Year Final Research Report
A clinicat study for the prediction using MRI images and pharamacological prevention
| Project/Area Number |
16K10245
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Psychiatric science
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| Research Institution | Tokyo Medical and Dental University |
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Principal Investigator |
Kurumaji Akeo 東京医科歯科大学, 大学院医歯学総合研究科, 非常勤講師 (00251504)
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Keywords | せん妄 / MRI 検査 / 予測因子 / 術後せん妄 |
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| Outline of Final Research Achievements |
Delirium is a common neurobehavioral disturbance in older patients after surgery. In the present study, the patients with the age range from 58 to 87 underwent an elective cardiac operation during 2 periods, i.e., August 2005 ~ August 2006 and July 2016 - December 2018. The total subjects included in the two studies were 175. Before the surgery, an MRI study was conducted. The MRI data were processed to calculate the absolute volumes of the pre-defined region of interest using SPM-8. The delirium was diagnosed according to the DSM-IV criteria.
The present study revealed that thirty-two of the 175 patients (18.3%) developed delirium. Based on a comparison to the age-controlled non-delirium patients, a statistically significant reduction in the GM volume of the delirium patients was observed in the widespread cerebral cortices as well as in the cerebellum. Hence, the atrophic change in the GM can be associated with the vulnerability to delirium after cardiac surgery.
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| Free Research Field |
精神医学
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| Academic Significance and Societal Importance of the Research Achievements |
これまで、術後せん妄の発症に、脳の形態学的な変化がどのように関与しているかは、あまり詳細には研究されていなかった。我々は、この疑問に関して、先行研究において、８４名の患者に関する研究を行ない、学術雑誌に報告しているが、本研究では、新たに９１名の患者に関する研究を行い、このふたつの研究を合わせることにより、１７５名というより多数の症例を検討することができた。
本研究は、大脳皮質、特に側頭葉の灰白質の体積の減少は、心臓血管手術後のせん妄の予測因子として重要なものであると同時に、せん妄発症への脆弱性およびその病態生理に関与していることを示唆する重要なものである。
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